Freezing Fat and the Flaky Fringe

Fat freezing is a rather weird FDA-approved treatment that has been around for a while, mainly under the name of CoolSculpting. What does their web page say?

The first paragraph seems out of touch with both logic and the language. It says, “Refreshments, such as tea, coffee, and water, are offered complimentary as patients relax and complete their treatments.” Okay, we get it, but the English is a bit wonky. “Our beautiful facility leaves no detail to the imagination” is totally meaningless. Also, the suite is “fully equipped with WiFi.” But is there such a thing as partial WiFi? Isn’t it either available, or not?

We are told that in the Cool Lounge, patients enjoy “a one of a kind atmosphere.” Uniqueness was also experienced by the Titanic lifeboat passengers. “One of a kind” is not an endorsement that inspires confidence. The point is, when a company plays fast and loose with language and logic, what does that imply about the service they bring to the marketplace? How does this modality work, anyway?

The term “cryolipolyisis” basically means Breaking up Fat via Cold:

Cryo=Cold
Lipo=Fat
Lysis= Break up.

When the patient is comfortably resting on the table, a protective gel pad is placed over the treatment area. A device is “pressed against the skin and tissue is drawn between two cooling plates.” By means of “gentle vacuum pressure and deep cooling,” it freezes the fat. More than one “specifically designed applicator” may be in use at any given time. For instance, both flabby areas known as love handles might be treated at once.

Another video, “Is CoolSculpting Right for You?” shows the process through animation, while the narration explains how the fat layer is significantly reduced because the treatment “targets and cools fat cells to temperatures that trigger their natural death…”

In one place, the literature says the freezing cycle is one hour, but in another place mentions it might be up to three hours. This is hard to reconcile with the company’s print media ad encouraging readers to “lose stubborn fat without downtime.” The language of the magazine ad also subliminally suggests that each problem area needs only one treatment to be effective.

When done, the applicators are removed and the client is left with what looks like a stick of butter just beneath the skin. The clinic staff member massages the lump and “may also follow the massage with with additional technologies to further enhance your results.” The results are slow in coming. As one of the videos explains:

Over the next few weeks and months, the fat cells shrink and begin to die as the patient’s own body metabolizes them and naturally eliminates them.

Weeks and months? Again, this does not match with the magazine ad’s claim of “fast results.” It also doesn’t mention the side effects reported by clients in user forums. Some say the pain is “horrific” and advise planning to take several days off from work.

Bruising might be extensive, and there might be an itchy rash on any or all body parts, from the immunological response known as histamine release. If the person has already lost some weight and has loose skin, the procedure does not tighten the skin and indeed makes it looser.

For the tech website Gizmodo, Kate Knibbs describes in detail how the dead fat cells are attacked by white blood cells and converted into triglycerides which the liver gets rid of. She then enumerates the caveats:

Since the amount of fat that dies is so small, it’s not likely to result in a change on the scale, and patients can only expect 20-25% “permanent reduction in fat” for the small frozen area… Patients lose, on average, around 40 cubic centimeters of fat, according to a study conducted at the Massachusetts General Hospital. One pound is around 450 cc’s, so a 40 cc loss is miniscule.

The fees charged for fat-freezing treatments can easily run into the tens of thousands, although one company offers a home fat-freezing kit for only $300.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade. You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow's 2017 Workshop on Treatment of Obesity Using the Addiction Model